Introduction: The disease state of COPD patients evolves over time. However, the electronic health record (EHR) does not automatically update. This can cause a discrepancy between the current health status and the information in the EHR, which could lead to suboptimal treatment.
 
Aims: To examine the extent to which GOLD stage based on spirometry and anxiety and depression data in the EHR reflect the current health status of COPD patients.
 
Methods: The population consisted of patients with COPD and comorbidities under treatment in secondary care being enrolled in a cohort study or a randomized controlled trial. Measurements from the study baseline visit were compared with data in the EHR using the McNemar test and Cohen's kappa.
 
Results: We found a statistically significant difference between the GOLD stage listed in the EHR and measured at baseline. According to the EHR and baseline spirometry respectively, 46.7% and 57.1% had GOLD stage II, 43.5% and 37.7% stage III, and 10.4% and 5.2% stage IV of all patients (n=154) (weighted kappa 0.65; p < 0.001). There was also a statistically significant difference between reported anxiety and depression in the EHR and measured by the HADS score at baseline (p < 0.001). Of all patients (n=196), 11.2% suffered from anxiety and/or depression according to the EHR and 49.5% according to the HADS score (kappa -0.104; p = 0.021).
 
Conclusions: There was a statistically significant difference in GOLD stage and anxiety or depression between the EHR and the current health status. Anxiety and depression were mostly underdiagnosed in the EHR. This problem could be solved by more regular screening for symptoms of anxiety and depression.